The Essentials Diabetes Management · 2021. 3. 5. · refers to the total number of calories, or “energy,” supplied from all sources (fat, carbohydrate, protein, and alcohol)

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The Essentials of Diabetes Management Toolkit




• Preparing for Change

• My Diabetes Record

• My Current Medications

• Diabetes Medications

• New and Improved Nutrition Facts Label

• Diabetes Action Plan

• Writing SMART Goals

Table of Contents

This toolkit contains

resources to help you

effectively manage your

diabetes.

The Essentials

of Diabetes Management Toolkit




Directions: Write down the healthy lifestyle (behavior) change you want to make. Then complete the following activities to help you identify your desire, reasons, need, and ability to change. All these components help determine your readiness for change.

List the healthy behavior change you want to make:

On a scale of 0 to 10, rate how important each reason is. (0 = not important at all;

10 = extremely important)

Preparing for Change

Activity 1 – Identify PrioritiesList your top life priorities in order of importance, for example, work, family, health, social activity. How will your healthy behavior change fit into your lifestyle? How will it impact your priorities?

•

•

•

•

•

Activity 2 – Identify MotivationList the reasons why you want to make this healthy behavior change:

•

•

•

•

•

Activity 3 – Identify ConfidenceOn a scale of 0 to 10, rate your confidence level for making this change. (0 = not confident at all; 10 = extremely confident) My rating is:

Answer the following questions to help identify prior successes and challenges to improve your confidence level: Why are you at this level and not a lower one? For example, have you had past success or have a good support team?

What would help you improve your confidence level? For example, do you need support or information?

Don’t worry if your rating is low. You can take small steps toward change regardless of your confidence level.




Every Visit: Date of Visit Result Date of Visit ResultReview blood glucose readings

Blood pressure check (<140/90)*

Weight

Foot exam

Review meal plan

Review activity level

Discuss questions or concerns

Every three to six months:

A1C blood test (<7%)

Every year:

Physical exam

Dilated eye exam

Complete foot exam

Cholesterol Total

HDL (men >40, women >50)

LDL (<100)

Triglycerides (<150)

Urine test for protein

Flu shot

Ask your doctor about:

Date Completed Date CompletedGetting a pneumonia shot Stress management

Aspirin therapy Unusual symptoms

Quitting smoking New treatments

Sick day plan

This document is for general information only and is not intended as a substitute for professional medical care.

Below is a list of items for good diabetes care recommended by the American Diabetes Association. Track your diabetes information and review this with your doctor regularly.

My Diabetes Record

Content reprinted with permission from the American Diabetes Association.




Name and Dose (number of mgs) Used For How Often and

When to Take Notes Start Date

Prescription medicines

Nonprescription medicines and dietary supplements

My Current Medications


Content reprinted with permission from the American Diabetes Association.




Diabetes MedicationsDrug Class Examples How the Medication WorksBiguanides

q Glucophage, Glucophage XR – metforminq Other: ______________________________________________

y decreases the liver’s glucose production and insulinresistance in liver, muscle and fat cells

y may also improve blood lipid (fat) levels

Sulfonylureas q Glucotrol, Glucotrol XL – glipizide

q Amaryl – glimepiride q Other: ______________________________________________

y stimulates the pancreas to produce and releasemore insulin

y can be long-acting and may stay in the body up to72 hours, but most last 24 hours or less

SGLT2 Inhibitors q Invokana – canagliflozin q Jardiance – empagliflozinq Farxiga – dapagliflozin q Steglatro – ertugliflozin

y lowers blood sugar by causing the kidneys to removesugar from the body through the urine

DPP-4 Inhibitorsq Januvia – sitagliptin q Onglyza – saxagliptinq Nesina – alogliptin q Tradjenta – linagliptinq Other: ______________________________________________

y increases the body’s release of insulin in response to a risein glucose levels

y prolongs action of gut hormornes

y delays gastric (stomach) emptying

TZDs – Thiazolidinedionesq Avandia – rosiglitazoneq Actos – pioglitazone

y increases insulin sensitivity in muscle and fat cells

y helps decrease production of glucose in the liver andimprove blood lipid (fat) levels

Alpha-glucosidase Inhibitorsq Precose – acarbose q Glyset – miglitol

y slows down the digestion of certain carbohydrates, whichcan help keep blood sugar levels from rising

Meglitinides (Can cause low blood sugar)q Prandin – repaglinide q Starlix – nateglinideq Other: ______________________________________________

y causes a burst of insulin to be released when you eata meal

y has a short time of action for mealtime use

Dopamine Receptor Agonistsq Cycloset and Parlodel – bromocriptine

y helps lower blood sugar levels after a meal

BASs – Bile Acid Sequestrantsq Welchol – colesevalam

y a cholesterol-lowering medication that also reduces bloodsugar levels in patients with diabetes

GLP1 – Incretin Mimetics (Injectable hormones)q Trulicity – dulaglutideq Byetta – exenatide, Bydureon – exenatide XRq Victoza – liraglutideq Other: ______________________________________________

y increases insulin release with food, slows gastric emptyingand promotes feeling of fullness. Also helps suppressglucose from being released by liver and can help withweight loss

y regulates insulin production in the pancreas and therelease of glucose in the bloodstream (These are versionsof natural hormones.)

y taken as injections

Insulin (Can cause low blood sugar)q Rapid-acting – NovoLog® – aspart, Humalog – lisproq Regular or short-acting – Humulin R, Novolin Rq Intermediate-acting – NPH (Neutral Protamine Hagedom)

– isophaneq Long-acting – Levemir – detemir, Lantus – glargine,

Tresiba – degludec

y regulates blood sugar if the pancreas can’t produceenough insulin

y usually taken by injection or pump

y more than one type may need to be taken

y rapid acting (bolus) insulin lowers after-meal blood sugar

y intermediate or long-acting (basal) insulin control bloodsugar between meal and overnight


This chart does not imply endorsement of any type or brand of diabetes medication. It does not list side effects, adverse reactions, interactions or precautions. Only a doctor can recommend or prescribe these medications. Medications in these classes can cause low blood sugar. The U.S. Food and Drug Administration has approved the medications in this chart.

Visit www.tricare.mil and www.express-scripts.com/tricare for current benefit and prescription information.Source: American Diabetes Association at https://professional.diabetes.org/sites/professional.diabetes.org/files/pel/source/medications.pdf

and https://www.diabetes.org/diabetes/medication-management/oral-medication/what-are-my-options




1

New and Improved Nutrition Facts Label The U.S. Food and Drug Administration has updated the Nutrition Facts label on packaged foods and beverages with a fresh design that will make it easier for you to make informed food choices that contribute to lifelong healthy eating habits. Explore it today!

Size Up Servings WHAT’S NEW: Servings per container and serving size are now in larger and/or bolder type. Serving sizes have also been updated to be more realistic to reflect what people actually eat and drink today. Additionally, there are new requirements for certain size packages, such as those that are between one and two servings or are larger than a single serving but could be consumed in one or multiple sittings.

Serving size is based on the amount of food that is customarily eaten at one time. The nutrition information listed on the Nutrition Facts label is usually based on one serving of the food; however, some containers may also have information displayed per package.

• When comparing calories and nutrients in different foods, check theserving size in order to make an accurate comparison.

Servings per container shows the total number of servings in the entire food package or container.

• One package of food may contain more than one serving. Somecontainers may also have a dual column label, which shows the amountof calories and nutrients in one serving and the entire package.

Consider the Calories WHAT’S NEW: Calories are now in larger and bolder type and Calories from Fat has been removed because research shows the type of fat consumed is more important than the amount.

Calories refers to the total number of calories, or “energy,” supplied from all sources (fat, carbohydrate, protein, and alcohol) in one serving of the food.

• As a general rule: 100 calories per serving is moderate and 400 caloriesper serving is high.

• To achieve or maintain a healthy weight, balance the number of caloriesyou consume with the number of calories your body uses. 2,000calories a day is used for general nutrition advice. However, your calorieneeds may be higher or lower and vary according to age, gender,height, weight, and physical activity level. Check your calorie needs athttp://www.choosemyplate.gov.

Calories 240Amount per serving

Serving size 1 1/2 cup (208g)2 servings per container

% Daily Value*

Total Fat 4g Saturated Fat 1.5g

Trans Fat 0g Cholesterol 5mg Sodium 430mg Total Carbohydrate 46g

Dietary Fiber 7g Total Sugars 4g

Includes 2g Added Sugars Protein 11g

5% 8%

2% 19% 17% 25%

4%

The % Daily Value (DV) tells you how much a nutrient ina serving of food contributes to a daily diet. 2,000 caloriesa day is used for general nutrition advice.

*

Vitamin D 2mcg Calcium 260mg Iron 6mg Potassium 240mg

10% 20% 35%

6%

When You’ll See It Manufacturers will need to use the new label by July 26, 2018, and small businesses will have an additional year to comply. During this transition time, you will see the current or the new label on products.

http://go.usa.gov/xkHru Nutrition Facts label, visit: To learn more about the new

F D FACTS

January 2017







2 For more information, contact the U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition’s Food and Cosmetic Information Center at 1-888-SAFEFOOD (toll free), Monday through Friday 10 AM to 4 PM ET (except Thursdays from 12:30 PM to 1:30 PM ET and Federal holidays). Or, visit the FDA website at http://www.fda.gov/educationresourcelibrary

F D FACTSUse % Daily Value as a Guide WHAT’S NEW: The Daily Values for nutrients have been updated based on new scientific evidence. The Daily Values are amounts of nutrients to consume or not to exceed each day and are used to calculate the % Daily Value. Some of the Daily Values are based on a 2,000 calorie daily diet.

% Daily Value (%DV) shows how much a nutrient in one serving of the food contributes to a total daily diet. Use the %DV to determine if a serving of the food is high or low in an individual nutrient and to compare food products (check to make sure the serving size is the same).

• As a general rule: 5% DV or less of a nutrient per serving is low and20% DV or more of a nutrient per serving is high.

Choose Nutrients Wisely WHAT’S NEW: The nutrients that are required or permitted on the label have been updated. Added Sugars is now required on the label — aim for less than 10 percent of your total daily calories from added sugars. Vitamin D and potassium are also required on the label because Americans do not always get the recommended amounts. Vitamins A and C are no longer required since deficiencies of these vitamins are rare today.

Use the label to choose products that are lower in nutrients you want to get less of and higher in nutrients you want to get more of.

• Nutrients to get less of: saturated fat, trans fat, sodium, andadded sugars. Diets higher in these nutrients can increase the risk ofdeveloping high blood pressure and/or cardiovascular disease. Get lessthan 100% DV of these each day. (Note: trans fat has no %DV, so usethe amount of grams as a guide)

• Nutrients to get more of: dietary fiber, vitamin D, calcium, iron, andpotassium. Most Americans do not get the recommended amountof these nutrients, and diets higher in these nutrients can decreasethe risk of developing diseases, such as high blood pressure,cardiovascular disease, osteoporosis, and anemia. Get 100% DV ofthese on most days.

Calories 240Amount per serving

Serving size 1 1/2 cup (208g)2 servings per container

% Daily Value*

Total Fat 4g Saturated Fat 1.5g

Trans Fat 0g Cholesterol 5mg Sodium 430mg Total Carbohydrate 46g

Dietary Fiber 7g Total Sugars 4g

Includes 2g Added Sugars Protein 11g

5% 8%

2% 19% 17% 25%

4%

The % Daily Value (DV) tells you how much a nutrient ina serving of food contributes to a daily diet. 2,000 caloriesa day is used for general nutrition advice.

*

Vitamin D 2mcg Calcium 260mg Iron 6mg Potassium 240mg

10% 20% 35%

6%

Ingredients: Bulgur Wheat, Sauce (Water, Half and Half [Milk, Cream], Parmesan Cheese [Pasteurized Skim Milk, Cultures, Salt, Enzymes], Cheddar Cheese [Pasteurized Milk, Cultures, Salt, Enzymes], Olive Oil, Spice, Butter, Sugar, Xanthan Gum), Lentils, Corn, Green Beans, Red Beans, Potatoes. Contains: Wheat, Milk

Check out the Ingredient List The Ingredient List shows each ingredient in a food by its common or usual name in descending order by weight. So, the ingredient with the greatest contribution to the product weight is listed first, and the ingredient contributing the least by weight is listed last. The ingredient list is usually located near the name of the food’s manufacturer and often below the Nutrition Facts label.

January 2017




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Most people start with an outcome goal. An example of an outcome goal is: “The overall goal I want to reach is to live healthier and lose two inches around my waist.”

To reach an outcome, you must have behavior goals. For example: “I want to walk five days a week for 30-60 minutes a day.”

The chart below shows a brainstorming process to break this behavior goal down into a weekly SMART behavior goal. This is an example of what the final weekly SMART goal might be: “This week I will walk 15 minutes a day at a brisk pace for three days.”

Specific What, when, where, and how will the behavior be done?

AttAinAble What are your steps to meet or reach your goal? Set your goal low enough to be reached, but high enough to be a challenge.

RelevAnt Is it the right behavior goal to help you meet your overall outcome? Is it a good time in your life to be setting this goal?

time-bound Make sure your goal includes a specific time frame in which you will achieve it.

Now it’s your turn. Write and track your own SMART goal.

Breaking down the steps to writing a Specific,

Measurable,

Attainable, Relevant, and

Time-bound (SMART) goal.

meASuRAble How much, how many, and/or how often will you do the behavior?

Goal Component Example

I want to walk regularly (at least five days a week) in the morning to help me reduce inches around my waist.

I want to walk 30-60 minutes a day at a brisk pace five days a week.

I will start walking 15 minutes a day for three days a week and work up to 30 minutes a day for five days a week. Seven days might be too high (no room for unexpected events or illness). One day is too low and not enough to help me lose inches.

Now that my children are back in school and the holidays are over I can start walking in the morning.

I will increase my time each week by five minutes until I reach 30 minutes a day. I will add an extra day every two to four weeks until I reach 30-60 minutes for five days a week.

Writing SMART Goals

Documents

The Essentials Diabetes Management · 2021. 3. 5. · refers to the total number of calories, or “energy,” supplied from all sources (fat, carbohydrate, protein, and alcohol)